Seems I’m hearing a lot more about the importance of Vitamin D in the last few years. And this time of year as the days shorten and sunshine becomes a rare treat, it is timely vitamin to address. We have long understood the link between Vitamin D and bone health. Those of you who remember the practice of giving cod liver oil to children to prevent rickets are witness to this old-time knowledge. Cod liver oil is an excellent source of nutritional vitamin D. Since vitamin D is known to help absorption of calcium, menopausal women often are advised to take it with calcium to help prevent osteoporosis. Studies now suggest that Vitamin D does a whole lot more than effect the bones. Low vitamin D levels during pregnancy are being linked to more preeclampsia, low birth weight and premature labor. Low vitamin D levels in childhood are now being linked to development of asthma, diabetes and high blood pressure in later years. A recent study published in the Journal of Nutrition suggests that women with vitamin D deficiencies may have more bacterial vaginosis, a common vaginal infection. Other research links low vitamin D levels to higher rates of colon and breast cancer, depression, diabetes, heart disease, weight gain and chronic pain. Wow!
Chances are that if you live in Michigan you are vitamin D deficientor at least insufficient. Your risk is even greater if you are older, dark skinned or cover your skin while outside. Experts in the medical community generally agree that vitamin D deficiency among women is widespread. Some predict that as many as 70% of white people and 97% of black people are deficient. Vitamin D is either synthesized in the skin through exposure to ultraviolet B rays in sunlight or ingested as dietary vitamin D. However it is difficult for humans to get adequate vitamin D from diet alone. And our Michigan climate and latitude make it difficult to get enough sun exposure. Then there is the dilemma of increasing the risk of skin cancer with sun exposure. Sun screen blocks the skins ability to synthesize Vitamin D. What is a person to do?
Get your vitamin D level checked. Ask your health care provider about getting this simple blood test the next time you go for an exam.
Consider taking a supplement. There is no general agreement about the optimal intake of vitamin D. Some researchers say the current recommended intake of 400 international units (IU) to 600 IU daily is inadequate and suggest a much higher daily intake, from 1,000 IU to 5000 IU. Cholecalciferol is the preferred form. It is easily available in any drug store and not terribly expensive. If your blood levels are low your health care provider may give you with a high dose prescription form of vitamin D. Experts reassure that it is rare and dificult to get too much Vitamin D but check with your care provider.
Include nutritional sources of Vitamin D in your diet. Look for vitamin D fortified foods such as milk,cereals, orange juice and yogurt. Other foods with vitamin D include tuna, salmon, beef liver, egg yolks, cheese. ( and of course cod liver oil if you can stomach it)
Continue limited sun exposure. (if you can find it!) Most experts say that 15-30 minutes of sun exposure without sunscreen is reasonably safe. Getting this amount most days of the week can help boost most peoples vitamin D levels safely.
An almost inevitable consequence of menopause is thinning bones. And why is that important? Because if bones get too thin they break. Broken bones lead to even more serious problems. Thin bones, also known as osteoporosis can cause any bone to break particularly with a fall, but the most common bones to fracture are vertebrae, hip and wrist.
BONES ARE IMPORTANT BECAUSE… Almost 300,000 Americans over 45 are admitted to the hospital with hip fractures each year. Osteoporosis was the underlying cause for most of these injuries. An average of 24% of hip fracture patients over 50 will die in the year following their fracture. Of those who were ambulatory before their hip fracture, 20% will require long term care after. Six months after a fracture only 15% will be able to walk across a room unaided. Ten million people in the U.S. have osteoporosis and 80% of those are women. Another thirty four million have low bone mass putting them at risk for osteoporosis. Costs of osteoporosis fractures are about $20 billion dollars a year and are expected to rise to over $25 billion by 2025.
KNOW YOUR RISKS…Asian and Caucasian women are at greatest risk. But significant risk has been reported in all ethnic backgrounds. Ten percent of Hispanic women have osteoporosis and 49% have low bone mass. Five percent of African-American women have osteoporosis and another 35% have low bone mass. Other risk factors include: family history; poor diet low in calcium and Vitamin D, excess intake of protein,sodium and caffeine; lack of exercise, smoking; excess alcohol;certain medications such as steroids and anticonvulsants; certain diseases such as rheumatoid arthritis, anorexia nervosa, gastrointestinal diseases.
KNOW WHAT TO DO TO DIAGNOSE… If you are over 60 or have other risk factors ask your care provider about getting a bone mineral density test (BMD). Most experts recommend a type of BMD called a DXA scan. This scan can tell if you have osteoporosis or low bone mass and help predict the chances of fracture in the future. This will guide you and your health care provider in the decision about need for treatment. Medications can help halt the progress and even reverse osteoporosis reducing the chance of fracture.
KNOW WHAT TO DO FOR PREVENTION…Tell your daughters, granddaughters, neices to drink their milk! About 85-90% of bone mass is acquired by age 18 in girls. Building strong bones early helps prevent osteoporosis later. Get enough calcium and vitamin D. Calcium 1200-1500 mg per day for those over 50 years old. Many experts are now recommending at least 1000 IU of Vitamin D per day. Avoid smoking and alcohol. Weight bearing exercises have been shown to reduce loss of bone density. Strength building exercises reduce risk of falling and therefore fracture risk.
KNOW WHERE TO GO FOR MORE INFORMATION… A couple good web sites are: www.nof.org (National Osteoporosis Foundation) for more information on osteoporosis and www.strongwomen.com for information on exercise.
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